Published online: 2019-12-31
Book Review
Principles and Practice of Wound Care
Sujata Sarabahi, V. K. Tiwari
Edition 2011
Publisher: Jaypee Brothers Medical Publishers (P) Ltd.
No. of pages 468
W
hen we go through this multi‑authored book,
the first two things that strike at once are
its comprehensiveness and its well‑designed
layout, and the editors of this book need to be
complimented for their effort. ‘Wound Care’ is a vast
subject when one intends to discuss both principles
and practices, and the editors have very aptly chosen
the topics and then designated them to appropriate
authors. Not only have they succeeded in covering all
types of wounds but all factors influencing wound care
like nutrition, oxygenation, negative pressure, etc. have
also been deliberated in great detail. This book is also
special because all the contributing authors have kept
the science petty simple so that this book can be of
use to general surgeons, orthopaedic surgeons, plastic
surgeons, students, research workers, technicians and
nurses.
This book is broadly divided into four sections: History
and Healing, General Principles of Wound Management,
Types of Wound and their management and Miscellaneous.
In the section on ‘History and Healing’, there are five
chapters. ‘Evolution of Wound Care’ by Dr. Savita Arora
is about wound management through the ages starting
from the days of Sushruta well before the birth of Christ,
through the Middle Ages and the Renaissance period,
the period between sixteenth and ninteenth century, the
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period thereafter, right up to the recent times with all
its advances! Dr. Harsh Mohan’s chapter on ‘Pathology
of Wound Healing’ discusses about the phases of wound
healing, types of healing, factors influencing wound
healing, complications of healing and briefly touches
on certain recent advances like oxidized regenerated
cellulose and biodegradable scaffolds.
The chapter on ‘Recent Advances in Wound Healing’,
authored by Dr. Mary Babu, is about management of
fibrotic wounds and chronic ulcers and how recent
advances have helped them. She proposes an ideal
dressing which will do wound cleansing, remove
exudates, provide a moist environment, prevent trauma,
and be easily available and economical. The chapter also
refers to skin substitutes, tissue engineering and stem
cells.
The editor, Sujata Sarabahi’s chapter on ‘Scars following
Wound Healing’ has a classification of scars, describes
differences between hypertrophic scars and keloids,
talks about the various scales of scar assessment and
scar management by surgical and non‑surgical means like
pressure therapy, silicone gel/sheet, massage, splintage,
steroids, inhibitors of gene transfer, flavonoids, lasers,
radiations, cryotherapy, intralesional antimetabolites,
skin fillers and tattooing. The chapter on ‘Classification
of Wounds’, penned by Dr. R.S. Mohil, discusses
about the classification on the basis of the amount of
contamination in the wound and whether these wounds
are contusions, lacerations, bruises, puncture wounds,
bites, traction/avulsion injuries, crush injuries or ulcers.
The chapter also discusses about healing by primary,
delayed primary and secondary intentions and by
epithelialization.
Indian Journal of Plastic Surgery January-April 2012 Vol 45 Issue 1
 Bhattacharya: Book Review
The section on ‘General Principles in Wound Management’
has six chapters. Dr. R.K. Chittoria has beautifully
illustrated the principles of ‘Wound bed preparation’,
which gives a structured and systematic approach to the
management of a non‑healing wound, discusses the TIME
principles, and ends in a very informative flow chart.
‘Initial Management of Life Threatening Wounds’ by
Dr. Sushma Sagar is about life‑saving management in
faciomaxillary wounds, crush wounds of limbs and open
chest and abdominal wounds with immediate risk of
underlying organ damage, exsanguinations and death
and delayed risks of sepsis and prolong morbidity.
Dr. S. Raja Sabapathy’s chapter on ‘Debridement –
Preparing the Wound Bed for Cover’ is about the
evolution of the concept of radical debridement from
the previously practiced serial debridement. This
chapter deals at length about the technique of radical
debridement under tourniquet, ample wound irrigation
and perfect haemostasis. The chapter also deals with other
non‑surgical modalities of debridement: Hydro‑surgical,
biological (maggots), enzymatic and the role of antibiotics,
skin soabs and tetanus prophylaxis.
Dr. Mohit Sharma’s chapter on ‘Dressings and Topical
Agents in Wound Care’ discusses about the rationale
behind wound dressings, aims of these dressings
and characteristics of an ideal dressing. Dressings
have three layers: Contact layer, absorbing layer
and binding layer and they can be non‑resorbable,
occlusive, hydrophilic/absorptive, and hydrogel. Topical
agents – antimicrobials, growth promoting agents,
matrix forming agents and topical debriding agents also
find a mention in this chapter.
The co‑editor, Dr. V.K. Tiwari’s chapter on ‘Surgical
Closure of Wounds’ deals with the technique of wound
closure, classification of sutures and needles, and newer
closure techniques such as adhesives, skin staples and
adhesive tapes. The chapter also describes in detail
all aspects of skin grafting. Dr. V.K. Malik’s chapter on
‘Surgical Site Infection: Prevention Strategies’ is about
epidemiology of such infections, how to reduce them by
measures before surgery and during surgery in the OR.
The author also evaluates the characteristics of various
antiseptic skin preparations in terms of anti‑microbial
coverage, onset and duration of action and their clinical
application. Dr. Malini Capoor in her chapter on fungal
wound infection talks about epidemiology, clinical
Indian Journal of Plastic Surgery January-April 2012 Vol 45 Issue 1
features, diagnosis and management of these infections.
The third section on ‘Types of Wound and Their
Management’ is the largest and has 21 chapters. Each
chapter describes wounds in unique locations and of
unique aetiology. Thus in this section we find chapters on
crush injury of limbs, skin avulsion injuries, diabetic foot
infections, vascular ulcers, venous ulcers, management
of burn wounds, radiation wounds, pressure sores,
trophic ulcers on feet, necrotizing fasciitis, bite wounds,
malignant wounds, gun‑shot wounds, upper and lower
limb wounds and foot defects. Giving due importance to
the commonly observed diabetic wounds four chapters,
authored by four different authors, on various aspects of
this infective pathology are given in this section.
Dr. Harish Chellani’s chapter on ‘Issues in Neonatal Wound
Management’ discusses about epithelial stripping,
neonatal burns, thermal injuries, pressure/ischaemic
injuries, extravasation injuries, excoriations, wounds
due to birth trauma and neonatal conditions like
epidermolysis bullosa and meningomyelocele. The
chapter also recommends guidelines to prevent neonatal
trauma and offers best practices and dressing changes.
Section 4 is a collection of four chapters on miscellaneous
subjects. Dr. Morris Topaz in his chapter on ‘Role of
Regulated Negative Pressure Therapy in Wound Healing’
describes the indications and physical basis of RNPT and
goes on to illustrate the clinical application of RNPT
and regulate oxygenation+RNPT in necrotizing fasciitis,
diabetic foot, for fixation of split skin graft, pressure
sores, venous ulcers, and compound fractures.
Dr. Karoon Agarwal’s input on ‘Role of Nutrition on
Wound Healing’ defines normal nutritional requirements,
nutritional assessment and the role of each component of
nutrition in wound healing. Dr. Ram Shanmugam’s chapter
on ‘Role of Physiotherapy in Wound Healing’ discusses
the role of exercise therapy, electrical stimulation,
ultrasonic therapy, ultraviolet therapy, laser therapy
and hydrotherapy in healing wounds. Dr. Ashish Rai’s
segment on ‘Hyperbaric Oxygen Therapy in Management
of Wounds’ gives us an overview of the history of use
of this modality, mechanism of oxygen transport in HBO
therapy, the role of oxygen in wound healing and the
therapeautic protocol with complications of using this
modality.
The book is privileged to have a very crisp foreword
168
 Bhattacharya: Book Review

penned by Dr. S.P. Bajaj, a very innovative thinker of our
time and a burn surgeon par excellence. It was released
in February this year during the Annual Conference of
the National Academy of Burns India in New Delhi. The
468 page book is hard bound, single volume and has
been published by Jaypee Brothers Medical Publishers (P)
Ltd. New Delhi. I am of the opinion that this book must
find a place in every library, frequented by students and
surgeons of all hue and colour, nurses, and technicians. It
is an ideal reference book for all who deal with intractable
wounds in their practice. Now does that leave behind
many in this profession?
Surajit Bhattacharya
Editor, Indian Journal of Plastic Surgery
E‑mail: surajitbh@yahoo.co.in

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